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JA USVI - A Day with Disney Registration
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Last Name
Your answer
First Name, Middle Initial and Suffix (Jr, III)*
Your answer
Gender
*
Male
Female
Email
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Contact Number
*
Your answer
Mailing Address
*
Your answer
Emergency Contact Name (Last, First, MI, Suffix)
*
Your answer
Emergency Contact Number
*
Your answer
Relationship to Emergency Contact Person
*
Parent
Guardian
Sibiling
Other
High School
*
Charlotte Amalie High School
Ivanna Eudora Kean High School
St. Croix Educational Complex High School
St. Croix Central High School
St. Joseph Catholic High School
St. Peter and Paul High School
All Saints Cathedral School
Antillies
STT/STJ Seventh Day Adventist School
Virgin Islands Montessori School & Peter Gruber International Academy
STX Seventh Day Adventist School
Gifft Hill School
Other:
Grade Level
*
9th Grade
10th Grade
11th Grade
12th Grade
Ethnicity
*
Black
Hispanic
Indian
Caucasian
Mixed
Other:
Is this your first time joining Junior Achievement?
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Yes
No
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